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New Research Examines Firearm Culture in Families of Youth Who Died by Firearm-Suicide

  • May 20, 2023

San Francisco — A new study, released today at the American Psychiatric Association’s Annual Meeting, examined perspectives on firearms among the families of youth who completed suicide by firearm, and found that in many cases, youth who died by gun-related suicide had been introduced to these weapons through culturally rooted familial traditions. The researchers also examined family members’ perspectives on suicide prevention interventions, including the State of Maryland’s Extreme Risk Protective Order Law, passed in 2018.

The study involved 2.5-hour semi-structured psychological autopsy interviews with the loved ones of nine youths, aged 17-21, who died from firearm-related suicide. Next of kin were approached by the Maryland Office of the Chief Medical Examiner to request consent for contact by the research team. Clinicians on the research team conducted interviews and a team of two researchers analyzed the interviews and identified and reached consensus on interview themes.

Most families had some degree of familial engagement with firearms. In more than two-thirds of the families, the youth used family-owned firearms when completing suicide. Over three-quarters of the youth had received mental health care prior to their deaths, with many receiving care in the weeks prior to their passing. In many cases, parents shared that they had not considered their family-owned firearms to be sources of danger. Several parents noted that if a clinician had expressed concern about firearm risk, they may have acted to reduce the risk. Several also shared that they would have considered using Maryland’s Extreme Risk Protective Order Law if it had existed at the time and they were made aware of it.

Suicide represents the second leading cause of death among youth, with half of those deaths involving firearms. This study furthers understanding of diverse culturally rooted familial firearm narratives and suggests that these narratives influence parents’ thinking about firearm risk, including when their children show warning signs of suicide. The authors conclude that “successful suicide prevention interventions must work to help families rescript firearms from tools seen as markers of familial cohesion and conveyors of intergenerational history to instruments that pose a threat to youth with suicide risk factors.” The findings are part of continuing efforts to interview the next-of-kin, family, and friends of youth who died by firearm suicide, with ongoing results and analysis anticipated.

The study authors included Matthew Kelly, Ph.D., M.P.H., Johns Hopkins School of Medicine; Aubrey DeVinney, B.A., Johns Hopkins Bloomberg School of Public Health; Holly Wilcox, Ph.D., Johns Hopkins Bloomberg School of Public Health; Ling Li, M.D., Office of the Chief Medical Examiner, Baltimore, MD; and Paul Nestadt, M.D., Johns Hopkins Medicine.

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,000 physician members specializing in the diagnosis, treatment, prevention, and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit

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